What is Incontinence?
Incontinence is common affecting approximately 1 in 4 women at some time in their life, so if you have trouble with bladder control you are certainly not alone. Involuntary loss of urine can deprive you of sleep leaving you tired, make travel difficult and keep the joys and benefits of exercise out of reach. Despite these limitations fewer than half of sufferers look for help, often because of embarrassment or because they do not realise help is available.
The 2 main types of urinary incontinence are URGE and STRESS.
Symptoms of Urge Incontinence;
-leaking of urine if one does not get to the toilet in time.
-getting up at night frequently during the night to urinate.
-going to the toilet at least 2 hourly.
Symptoms of stress incontinence;
-leaking of urine when one coughs,sneezes or laughs
-avoiding exercise for fear of leakage
-going to the toilet frequently to avoid accidents.
A mix of urge and stress is common.
Causes of incontinence;
–pregnancy and childbirth
-menopause
-post surgery e.g. hysterectomy
-prolonged staining [from chronic constipation]
-genetic factors
-prolapse
Physiotherapy Assessment
A detailed medical history will be taken. The pelvic floor muscle strenght will be examined. The patient will usually be asked to keep a bladder diary for 3 days to record input [drinks], output [urine] and wetting accidents. Based on assessment findings a treatment plan will be implemented.
Physiotherapy Treatment
May involve some or all of the folowing;
-retraining the pelvic floor muscles. The pelvic floor muscles have three main functions. 1. Supportive. These muscles and the associated connective tissues work with the deep abdominals, deep lower back muscles and the diaphragm to support the weight of the internal organs and structures [bladder, vagina and rectum] to resist the increased abdominal pressure when coughing, sneezing, jumping and lifting. 2. Sphincteric. These muscles work to compress the urethra and anus and in doing so maintain continence of urine, faeces and wind. 3. Sexual. These muscles make up the vaginal wall and need to be flexible to allow for pain free sexual activity.
-neuromuscular stimulation [an electrical device is used to help get a muscular contraction in very weak muscles-this will firstly be in the clinic but the client can then choose to rent the muscle stimulator for home treatment].
– biofeedback- a pressure sensitive device which shows whether you are contracting the correct muscles.
– bladder retraining
-posture correction- to help give pelvic floor muscles control over long periods of time.
-retraining the deep abdominal muscles which are thought to help the pelvic floor muscles work more effectively.
-vaginal cones- weighted tampon like devices can be prescribed to provide resistance training.
Treatment is highly effective with most patients reporting significant improvements or cure.
Recommendations for a healthy bladder;
-drink 1.5-2litres of fluid per day
-avoid caffeine, alcohol and fizzy drinks
-don`t go to the toilet “just in case”- wait until bladder is full.
-avoid constipation
– avoid heavy lifting
-do pelvic floor exercised regularly! We recommend a dvd available from www.amazon.co.uk. “Release to Balance” which gives detailed instructions on pelvic floor and abdominal exercises.
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